Treatment of pathological lesions in the brain

Human brain is a complex and sensitive organ that is highly affected by any kind of trauma and pathology. It is essential to diagnose benign or malignant lesions as early as possible and treat them appropriately, otherwise they may cause serious threat to a person’s quality of life, health and even life. Symptoms and possible complications of pathological formations directly depend on the size of the lesion and which part of the brain it located in. In order to avoid irreversible damage to the brain tissue, it is important to seek medical help, observe the first symptoms, and carry out preventive health tests that allow to discover formations at their earliest stages.

Stereotactic radiosurgery device CyberKnife® is able to effectively treat pathological vascular formations in the brain that are no larger than three centimeters, deeply localized and compact. The unique technology also makes it possible to treat lesions that are difficult or impossible to reach surgically due to their specific location. It’s an opportunity to carry out a painless treatment procedure without surgical intervention while saving the healthy tissue; in addition, there is no need to hospitalize the patient. The procedure is comfortable and allows the patient to breathe freely and relax. In comparison to surgery, Cyberknife® technology causes fewer complications and the patient’s quality of life remains higher.

Arteriovenous malformation is a tangle of pathological blood vessels connecting arteries and veins in the brain. The disease is relatively rare and is observed in only 1% of the world’s population; however, it can cause dangerous complications resulting in serious symptoms and threat to the patient’s life. The causes of arteriovenous malformation are unclear, but the majority of professionals believe it forms already during the fetal development period.

Arteries of a healthy individual draw blood from the heart to the brain gradually – flowing through many smaller blood vessels, they reach the capillaries where oxygen is slowly transferred to the brain tissue, and then goes back to veins that take it back to the heart and lungs. Arteriovenous malformation lets the blood rich with oxygen flow directly into the venous system bypassing the surrounding tissue, smaller blood vessels and capillaries.

The symptoms of the disease can occur at any age, most commonly – at the age of 10 to 40. Since the malformation constantly affects the brain’s blood vessels, the signs can become stronger and more dangerous over time. Symptoms vary depending on the formation’s size and the area of the brain it is located in. Patients can experience headache of various intensity, muscle numbness, or weakness in certain body parts. In more severe cases, symptoms include extreme headache, general muscle numbness, impaired memory, weakness or paralysis, impaired sight, speech and sense of balance, as well as confusion, inability to interact with other people, hallucinations or dementia. These health disorders can be transient – they might disappear for a while and reappear again after a certain period of time. Very often arterial malformations do not cause any significant symptoms, and it is discovered only during a brain scan to diagnose another disease or only when the formation has already caused complications, most commonly – a brain hemorrhage.

Arteriovenous malformation causes intense pressure to the walls of veins and arteries reducing their thickness and durability. Over time, a rupture in the formation can occur, which causes bleeding in the brain – hemorrhage. The risk of such hemorrhage increases approximately by 1 to 4% each year. Malformation can also cause brain tissue damage. Without sufficient oxygen supply, the tissue is weakened or killed, which makes the patient to suffer from symptoms similar to those of a stroke – impaired speech and sight, weakness, tingling and severe imbalance.

Pathological vascular formations in the brain can be detected by computed tomography (CT) or magnetic resonance imaging (MRI) and cerebral angiography (CA), that is the most detailed test to diagnose an AVM. CA test reveals the location and characteristics of the feeding arteries and draining veins, which is critical to planning treatment. CT and MRI can determine the size and location of the formation, as well as detect whether there have been any minor hemorrhages in the brain that can damage the surrounding tissue without causing any unpleasant symptoms. Based on the test results, it is possible to create a precise individual treatment plan, which allows to effectively prevent from the disease, while reducing the risk of its dangerous complications. Appropriate treatment is set by the patient’s treating specialist, taking into consideration the patient’s age, general health condition and the size and location of the pathological formation. It can be treated surgically, by endovascular embolization or with the help of stereotactic radiosurgery. If a hemorrhage has already occurred, the formation is larger than three centimeters or is located in a brain area that is easy to reach, most commonly a surgery is preferred. Endovascular embolization is less invasive than traditional surgery. It may be performed alone, but is frequently used prior to other surgical treatments to make the procedure safer by reducing the size of the AVM or the likelihood of bleeding. If the formation is small, does not endanger the patient’s life or is in a brain area that is difficult to reach, the most effective solution is radiosurgery. It is also advised for cases when the patient for some reason does not want to undergo a surgical manipulation. There are some cases when medical professionals decide to observe the formation – each year the patient must complete appropriate health tests that allow to detect any changes in the formation structure.

Cavernoma is a cluster of enlarged and irregular blood vessels in the central nervous system. Capillary walls are thinner and less flexible than those of healthy blood vessels, and over time they become damaged causing brain hemorrhages. Blood vessel deformations also weaken the blood flow, disturbing proper blood circulation functions. The disease is observed in approximately 5% of the world’s population, but not always does it lead to health problems. The cause of cavernoma is gene mutation that is hereditary or developed over the individual’s lifetime.

Since pathological blood vessels can occur in any part of the brain, each cavernoma patient may experience different symptoms with varying scale of intensity. Approximately 15 to 25% of the cavernoma patients do not experience any disease symptoms or health problems related to vascular pathology during their lifetime, while the remaining 75% observe various types of seizures, headache, impaired vision, hearing and sense of balance, numbness or paralysis in some body part, and some dangerous complications such as brain hemorrhage. These patients experience severe headache that gradually becomes stronger, nausea, neurological disorders, difficulty to concentrate and interact with other people, impaired consciousness and speech. In some cases occurring hemorrhages are negligible and show no obvious signs; nevertheless such bleeding causes serious damage to the surrounding brain tissue and their effects can appear over time. The risk of brain hemorrhage increases by approximately 1 to 10% each year, which directly depends on which part of the brain the cavernoma is located in.

In specific cases when the cavernoma is negligible and does not cause any direct threat to the patient’s health, medical professionals may decide to observe the formation – each year the patient must complete appropriate health tests that allow to detect any changes in the formation structure. In order to prevent from symptom attacks, medication therapy is often prescribed. In most cases, cavernoma requires treatment. Appropriate treatment is set by the patient’s treating specialist, taking into consideration the patient’s age, general health condition and the size and location of the pathological formation. Enlarged and irregular blood vessels in the brain can be discovered by brain computed tomography (CT) or magnetic resonance imaging (MRI). Cavernoma can be treated surgically or with the help of radiosurgery.

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